The Unstable Shoulder in the Adolescent Athlete

Abstract

Shoulder dislocation and subluxation occur frequently in athletes, with peaks in the second and sixth decades. The majority of traumatic dislocations are in the anterior direction. The most frequent complication of shoulder dislocation is recurrence--a complication that occurs much more often in the adolescent population. The dynamic (muscular) and static (predominantly capsuloligamentous and labral) restraints to shoulder instability are now well defined. Recent surgical procedures for shoulder instability have become less interventional and have focused on restoring disrupted static restraints. The aim of rehabilitation is to enhance the dynamic muscular and proprioceptive restraints to shoulder instability.

Prevalence Comparison of Accompanying Lesions between Primary and Recurrent Anterior Dislocation in the Shoulder

“…Multidirectional instability is then identified as a clinical syndrome that occurs when shoulder laxity produces symptoms. 1,7,14,15 Symptomatic multidirectional instability was diagnosed based on the following criteria: (1) current complaints of shoulder discomfort and symptoms of instability and (2) positive sulcus sign, either positive load-and-shift and/or positive apprehension test.…”

Rehabilitation for shoulder instability

“…The shoulder is the most mobile joint in the body and therefore susceptible to instability 2 3. Approximately 10% of all athletic injuries are shoulder injuries 4.…”

Arthroscopic Versus Conservative Treatment of First Anterior Dislocation of the Shoulder in Adolescents

“…There are studies that estimate recurrence rates up to 92%. [5][6][7] The most important factor for recurrence seems to be the age of the patient at the time of the first dislocation. 8,9 Many studies have compared the results of conservative treatment versus operative stabilization after a first traumatic shoulder dislocation.…”